Year: 2025 | Month: December | Volume: 15 | Issue: 12 | Pages: 181-193
DOI: https://doi.org/10.52403/ijhsr.20251223
Patterns of Broad-Spectrum Antibiotic Use in Paediatric Inpatients and Stewardship Opportunities
Akila E1, Sesathri2, Kavitha3, Uppalapadu Sudarsana4
1Assistant Professor, Department of Pharmacology, Government Medical College, Thiruvallur
2Professor, Bhaarath Medical College and Hospital, Chennai
3HOD & Professor, Sri Ramachandra Medical College & Research Institute, Chennai
4Assistant Professor, Department of Physiology, Rajalakshmi Medical College and Hospital, Chennai
Corresponding Author: Dr. Uppalapadu Sudarsana
ABSTRACT
Background: Infectious diseases are a major cause of paediatric morbidity and mortality, and hospitalised children are frequently exposed to antimicrobials. Understanding local prescribing patterns is essential to guide antimicrobial stewardship and curb emerging resistance.
Objectives: To describe the pattern of antimicrobial utilisation among paediatric inpatients aged 1–12 years, including demographic and clinical profile, spectrum of diagnoses, classes and routes of antimicrobials used, and the extent of microbiological testing supporting therapy.
Methods: This descriptive observational study was conducted using case records of paediatric inpatients aged 1–12 years who received at least one systemic antimicrobial during their hospital stay. A total of 213 case sheets were screened; 23 were excluded, and 190 were included. Data on demographics, diagnoses, antimicrobial agents (class, number, route and duration), microbiological investigations and length of stay were extracted using a structured proforma and analysed descriptively.
Results: The mean age of the children was 5.9 ± 3.1 years; 55.8% were male. The most frequent diagnoses were enteric fever (15.8%), bronchitis (15.8%), acute gastroenteritis (15.3%) and pneumonia (12.6%), with infectious diseases comprising the majority of admissions. All 190 children received antimicrobials, accounting for 300 prescriptions (mean 1.7 ± 0.8 agents per patient): 43.2% received one antimicrobial, 40.0% received two and 16.8% received three or more. Cephalosporins were the most commonly prescribed class (33.0%), followed by penicillins (18.0%), aminoglycosides (18.0%), fluoroquinolones (13.0%) and antiamoebics (12.0%). Parenteral-only therapy was used in 46.3% of patients, oral-only in 17.9% and both routes in 35.8%. Microbiological cultures were sent in 58.9% of cases, with 41.9% positivity among those tested.
Conclusion: Paediatric inpatients showed high exposure to antimicrobials with predominant use of broad-spectrum cephalosporins and frequent combination therapy. These findings highlight the need to strengthen paediatric antimicrobial stewardship, promote guideline-based prescribing and enhance culture-guided, targeted therapy.
Key words: Antimicrobial utilization; Paediatric inpatients; Antibiotic prescribing; Drug utilisation study; Cephalosporins; Antimicrobial stewardship